2010

Will California Legislation Promote Assisted Suicide?

By CAMILLE GIGLIO

May 30 2011 - San Francisco, CA - PipeLineNews.org - In a recently online published book entitled: This-Thing-Called-Hospice author Ron Panzer presents compelling arguments that Hospice may be at least one of the vehicles being prepared to actively promote acceptance of assisted suicide.

Currently only Oregon and Washington state have assisted suicide laws on the books. California is amongst 34 states that have, so far, established laws against assisted suicide.

Several states currently have legislation before them that would legalize assisted suicide. Several of these bills have been defeated due, mainly, to their overt pro assisted suicide language in the bills.

In California in 2008, AB 2747, End-Of-Life Decisions, was passed into law. It was heavily opposed by religious, right to life and disability rights groups. It was authored by Assemblywoman Patty Berg, a proponent of assisted suicide and sponsored by Compassion and Choices, a nationwide right to die organization with a branch headquartered in Northern California. http://www.compassionandchoicesnca.org/

The author agreed six (6) times to amend the bill removing the more obvious and egregious wording until it satisfied supporters and benumbed opponents of assisted suicide. It did not usher in official recognition of the act of assisted suicide, but it set up certain standards and approval for which groups' end of life care agenda might be recognized and publicized. That recognition consisted mainly of establishing a website with information available on line. The bill established the Patient's-Right-to-Know all the choices available for end of life health care decisions and it mainstreamed groups like Compassion and Choices, to have direct access to patients.

The following is a direct quote from the Compassion and Choices website for Northern California about AB 2747 [see, http://www.compassionandchoicesnca.org/advocacy.php]

"The Act is the first in the nation to provide terminally ill patients with a full disclosure of, and counseling about, all available end-of-life care options accepted in law and medicine. When requested, information about hospice care, refusal or withdrawing of life-prolonging treatments, voluntary stopping eating and drinking (VSED), palliative care and palliative sedation are discussed with the patient. The Act also requires that health care providers who do not wish to comply with a particular patient's request must refer or transfer the patient to another provider. The law went into effect for Californians on January 1, 2009."

All that has been needed to advance the assisted suicide cause has been opportunity and access to elderly, disabled and vulnerable patients along with tax funding of assisted suicide groups. Patients in their own homes and surrounded by loving family members are pretty difficult to access. Get all these patients out of their homes and into what they like to call home-like atmospheres(dressed up institutions) facilities and you have a captive and vulnerable audience.

Panzer's book strongly suggests that the federal government, through its Affordable Care Act, is positioning Hospice to be the door through which opportunity and access can seek out potential customers.

Ron Panzer is a Director of a Michigan based Organization entitled Hospice Patients Alliance - http://www.hospicepatients.org/. He is very proud of the work of hospice care as originally conceived by Dame Cecely Saunders, in 1979, in London, England.

What Panzer would like everyone to be alert to is that the concept of hospice care - pain and symptom control for a patient in the final six months or so of life, and supportive counseling for the family - has been invaded by groups who also believe that patients should have full control of the ending of their lives even to the point of choosing the means and timing of their own death, including requiring the physician to facilitate that choice. In other words, if I may paraphrase his warning, buyer beware. Know what philosophy you are working with. Is it respect for human life including life at its endings or is it a more humanistic approach to the end of life where the objective is to weigh the benefits against the cost of maintaining life for the individual patient.

During a recent phone interview with Mr. Panzer he pointed out that just a few years ago only 20% of patients with a terminal illness died in a hospice type facility. In 2009 it rose to 40% of patients. hospice receives government funding and is included in the Patient Protection and Affordable Care Act. Mr. Panzer asserts that hospice care is exempt from cuts in its funding through the PPACA.

For those patients who were on Medicare while receiving their hospice care it was a cost savings to the taxpayer. His book supplies statistics to show that it is less costly to provide hospice care to patients in a medical facility than it is to provide in-home hospice care. Providing pain control and palliative care to patients rather than prescriptions and curative care is cost effective. "The government" said Mr. Panzer, "would like to see 100% of terminally ill patients die in hospice facilities."

In his book he states it this way:

"The top level policymakers have decided that people will die in hospice or palliative care units, and that they will be pushed into hospice through a wide variety of means. $3.6 billion saved in one year. Think that motivates the government? That's nothing compared to the savings when the people placed into hospice doubles in the years to come. That's the plan. If patients are hurried along toward death, the savings skyrocket!" http://www.hospicepatients.org/this-thing-called-hospice.html

In three previous articles I have focused on one piece of California legislation, SB 135, Hospice Facilities, authored by Sen. Ed Hernandez and sponsored by the California Hospice & Palliative Care Association. This bill gives great emphasis to a current segment of the state Health and Safety Code beginning with section 1560 which identifies and provides definitions for several types of medical facilities including Congregate Living Health Facilities - CLHF.

This bill, admittedly, has no direct overt relationship to AB 2747 or any right to die organizations, but its purpose is shrouded in benumbing words and terms. Keeping in mind that the government just might want to get all disabled, elderly and indigent Medicare patients in hospice facilities, congregate living facilities would be authorized to provide for three separate types of licensing of care in the same facility. In other words, a congregate living health facility would have, for example, terminally ill and indigent cancer patients in the final stage of their illness, disabled elderly, but not imminently terminal, patients, even younger patients with a life threatening illness.

This situation, according to Panzer, is a form of stealth euthanasia. Grouping patients with different types and forms of illnesses and different end of life results can become a depressant to the more able and alert patients causing them to lose hope and thereby making them vulnerable to the messages of the assisted suicide philosophy.

There are currently 8000 licensed hospice facilities (including in-home services) in California. SB 135 recognizes that the current law limits hospice facilities to 12 beds. SB 177, Congregate Living Health Facilities, authored by Republican Senator Tony Strickland of Santa Barbara, (who is also a co-author of SB 135, would raise the number of beds (patients) to 24 per facility.

Combine this with screaming newspaper headlines such as "Seniors, disabled in budget cross hairs" an article by Sandy Kleffman of the Bay Area News Group - Contra Costa Times, dated 5/22/2011, designed to put fear into the hearts of all with elderly and fragile senior citizen family members that medical care for their loved ones is about to be drastically reduced. Gov. Jerry Brown's latest budget proposal, and a bill passed by state lawmakers in March, would eliminate Medi-Cal funding for 330 adult day health care programs statewide that serve more than 35,000 frail seniors and the disabled.

Further, a quote from Peter Behr, Administrator of the Guardian Center in El Sobrante, California, declares that: "We will be in a world of hurt," Behr said. "It would be a greatly reduced staffing level and a reduced number of people served. Some of them would end up sitting at home, without care.

But there are no funding cuts planned for this program, as a matter of fact legislators are seeking to expand funding.

Operative sections of SB 135 include, "It would amend five sections of the state Health and Safety Code Section beginning with Sec. 1260 relating to hospice care and add two new sections. Congregate Living Health facility - CLHF - would allow for a mix of disabled, terminally ill and frail elderly to live together in a home-like hospice facility. The life expectancy of any one of this group of patients may be anywhere from 6 months to 5 years. It will be staffed by Registered Nurses, physician assistants and Nurse Practitioners along with nutritionists, physical therapists, volunteers and management staff."The bill further states, "The primary need of congregate living health facility residents shall be for availability of skilled nursing care on a recurring, intermittent, extended, or continuous basis. This care is generally less intense than that provided in general acute care hospitals but more intense than that provided in skilled nursing facilities." According to the legislation, this facility would be in close proximity to a hospital and the facility would be limited to 12 beds. The bill creates a new crime and impose a state-mandated local program. These facilities will be entirely supported by federal funds and special funds, or, unless funds are specifically appropriated from the General Fund in the annual Budget Act or other enacted legislation.

The old saying, if it walks like a duck and quacks like a duck, it is a duck, applies here. The unfortunate reality here is that nobody seems to know what a duck looks like. There are too many different agendas bundled up here. Mr. Panzer being director of a hospice non-profit wants to see hospice care expand. Who would blame him? He just doesn't want it to include assisted suicide. The anti-euthanasia people say, we don't see any connection between AB 2747 and these two bills, SB 135 and SB 177. We need something more definite to fight. And, besides with AB 2747 the fight ended. Compassion and Choices won and we lost. We should have killed AB 2747 instead of allowing it on life support.

The politicians, like Republican Strickland, who apparently sees himself as a maverick legislator, wants to position himself as a compassionate conservative and do a favor for all those nice hospice and religious groups in his Santa Barbara district who are supporting his bill. Can you say re-election?

A spokesperson for Senator Strickland called to state that he would not be honoring our request for him to withdraw his support of these two bills because he doesn't believe that there is any hidden agenda in these bills.

SB 135 passed the Senate Health Committee on 4/27/11. It is scheduled for a hearing in the Senate Appropriations Committee for May 26, 2011. SB 177 has passed out of the Senate Appropriations so it's well on its way.